There is virtually no comparing the harms of tobacco/cigarette smoking and vaping.
Cigarettes are a one-way trip into a world of emphysema, heart disease, stroke and cancer.
I treat these conditions every day.

That we allow corporations to profit off this is repulsive.
At the same time we have a teen vaping explosion.

It's an 'adult only' product but of course that's just fiction.

Youth, especially teenagers (and even younger), are a vast and avid market for one of the fastest growing business sectors in New Zealand: vape sales.
If you spend any time around kids, you will have a stunning exposure to the extent of nicotine addiction in teenagers.
The growth of nicotine vapes marketed to kids (and used by them), is the #BusinessOpportunity of the decade.
So what would I like to see regarding #vapes and kids?
Unannounced, frequent, and recurring screening using underage buyers:

The first violation (illegally) selling vapes to kids, the shop gets a $10,000 fine.
The second time it occurs they get shut down permanently.
But also...Heavily subsidized (or free) vapes for anybody trying to decrease or stop a tobacco addiction.

And of course free primary care GP access, and free addiction treatment and counseling.

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More from @GaryPayinda

Mar 6
I'll offer up one possible answer.

But first, some comments 😀 For-profit health care will always neglect poor and working class folks.

Pvt biz will suck up health money treating the profitable patients. They'll avoid the sick, elderly, poor, and infirm like the plague.
🧵
So any health system that is predicated upon turning sick people into profits is doomed to failure.

The smart, profits are not in treating people with actual health needs.
Once we accept the basic truth that for-profit health care is about making as much profit as possible, and delivering as little health care as possible, we're getting somewhere.
Read 12 tweets
Mar 6
It's probably worth people learning about Epstein-Barr virus (human herpes virus 4).
It's a virus that pretty much everyone gets, the one that causes glandular fever, also known as #mononucleosis. 🧵
For many it's a simple cold, but for others it causes hepatitis, immunosuppression, autoimmune disease, and sometimes, several decades later, the neurodegenerative condition known as #MultipleSclerosis...

healthline.com/health/epstein…
It's worth talking about because it could easily be blown off as just a cold or a flu-like illness. Just like covid.
It infects white blood cells, lymphocytes, just like covid.
And it can cause a litany of acute and chronic medical problems, just like covid...
Read 12 tweets
Feb 19
Guideline summary for #ED docs on early pregnancy loss/miscarriage:
acog.org/clinical/clini…
10% of all #pregnancies end in #miscarriage, though the rate approaches 80% by maternal age 45yrs.
Half of early pregnancy loss (AKA miscarriages) are due to chromosomal abnormalities. 🧵
Crown-rump length (CRL) 7mm or greater and no heartbeat. Mean sac diameter (MSD) 25mm and no embryo.
Each one is an #ultrasound feature diagnostic of early pregnancy loss.
#POCUS
#medtwitter
80% of patients with early pregnancy loss can be safely managed with an expectant management (watch and wait) approach.
Relatively few miscarriages will require ED care; most of these will involve significant and symptomatic haemorrhage or infection.
Read 15 tweets
Feb 16
Ok, so he owns or part-owns investment companies, and private medical practice Whangarei doctors, and Primecare.
I'd really like to know that he does not own a stake in White Cross urgent care, who get taxpayer $ directly.
Maybe he'll address that. He's a recent follower.
In the past, Whangarei GPs have part-owned White Cross urgent care corporation. Is that still the case?
And ED patients get 'free' white Cross vouchers (paid for by your tax dollars of course) to go to (private corporation) White Cross when ED is understaffed/underresourced.
This takes away tax dollars from your public health service/ED/hospital.
Read 4 tweets
Feb 16
I can't believe this abomination of a law passed. It deserves to get destroyed in court.
Saliva drug testing is so inaccurate as to be untenable.
And you can be 100% sober, last sleeping pill days ago, or joint weeks ago, and you'll still test positive.

knowyourstuff.nz/2022/03/16/roa…
I'm no fan of drugs. I've never used drugs. I'm just a doctor telling you this "drug testing of drivers" is, scientifically speaking, rubbish.
People are pretending it's accurate, pretending it works, pretending it saves lives.
Mostly it penalises people who smoked marijuana.
It will be most effective at causing Maori and poor people to end up losing their jobs, or ending in court or jail, for having smoked cannabis days prior.
It's as inaccurate and regressive as it gets.
Read 6 tweets
Nov 17, 2022
Are we in a health crisis? Certainly.
Is it new? No, it’s been brewing for a long time.
What we’re seeing is the end-game of four decades of neoliberal policies feeding on the corpse of civil society. Finally it seems to have played itself out.
We’ve reached a point in time where the common man actually thinks taxes are bad. The same taxes that pay the surgeon who performs his gallbladder surgery, the teacher that educates his children, and the firefighters who protect his home.
People have been conditioned to not see taxes for what they are: the means by which citizens fund a functional and democratic society.
Read 17 tweets

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